Implication of cardiac marker elevation in patients who resuscitated from out-of-hospital cardiac arrest.
Am J Emerg Med
; 30(3): 464-71, 2012 Mar.
Article
em En
| MEDLINE
| ID: mdl-21296527
ABSTRACT
OBJECTIVES:
It is often difficult to diagnose acute myocardial infarction (AMI) in patients who resuscitated after out-of-hospital cardiac arrest (OHCA) and had a delayed elevation in cardiac marker. This study explored whether elevations in cardiac marker were due to coronary artery occlusion or resulted from other causes.METHODS:
The study included 19 non-ST-segment elevation patients who resuscitated after OHCA and underwent delayed coronary angiography. We checked patients' serial creatine kinase-myocardial band (CK-MB) and troponin I (cTnI) levels on arrival and 6, 12, 24, 48, 72, and 96 hours postarrest. Based on the association of elevated cTnI and the results of their delayed angiographies, the patients were retrospectively divided into 2 groups an AMI group (n=5) and a non-AMI group (n=14). We then analyzed the serial cardiac marker measurements in each group.RESULTS:
Peak marker levels were significantly higher in the AMI group than in the non-AMI group (CK-MB, 177.0±112.7 vs 66.4±85.2 ng/mL; P=.033 and cTnI, 40.4±14.5 vs 10.6±13.5 ng/mL; P=.005). After adjusting for covariates, the peak and 6-, 12-, and 24-hour cTnI and 6-hour CK-MB were significantly different between the 2 groups (P=.005, P=.004, P=.005, P=.020, and P=.007). In the non-AMI group, 3 patients had cTnI values that were within the reference range at all of the evaluated times. Most patients had only low cTnI elevations that rapidly fell back to normal.CONCLUSION:
The resuscitation of patients who experience sudden OHCA but do not have an AMI may lead to elevations of cardiac markers. However, these elevations are low and normalize early.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Reanimação Cardiopulmonar
/
Troponina I
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Creatina Quinase Forma MB
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Parada Cardíaca Extra-Hospitalar
/
Infarto do Miocárdio
Tipo de estudo:
Evaluation_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Am J Emerg Med
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Coréia do Sul